PREVALENCE AND REPAIR OF INGUINAL-HERNIAS IN CHILDREN WITH BLADDER EXSTROPHY

Purpose: We delineated the prevalence, recurrence rates and optimal tr eatment of inguinal hernia in the exstrophy population. Materials and Methods: Of 181 children with exstrophy followed at our hospital ingui nal hernias developed in 121 (66.8%). Results: In a 12-year period ing uinal hernias developed in 81.8% of the boys and 10.5% of the girls. I n 18.2% of the cases the hernia was repaired via a preperitoneal appro ach at the same time as exstrophy closure. The remaining patients unde rwent an inguinal operation. Most patients had a wide defect at the in ternal ring in addition to a patent processus vaginalis. The overall r ecurrence rate was 8.3%. The incidence of synchronous or asynchronous bilaterality was 81.8%. Conclusions: Children with bladder exstrophy s hould be carefully examined for inguinal hernias before bladder closur e. If a unilateral hernia is present, the contralateral side should be explored. Careful preperitoneal repair should emphasize repair of the internal ring.